An Analysis of the Presence of Coagulopathy on Arrival to Emergency Departments in Deployed Military Treatment Facilities.

Introduction: Acute traumatic coagulopathy remains a high predictor of mortality; however, the incidence and outcomes in the military population have limited data. The goal of our study is to characterize coagulopathy on arrival to deployed Role 2 and Role 3 Military Treatment Facilities (MTFs).

Materials And Methods: We utilized the Department of Defense Trauma Registry to identify United States (U.

Combat-related genitourinary trauma in pediatric patients: Data from the department of defense trauma registry.

Background: Deploying surgeons frequently train, prepare, and bring equipment to manage adult trauma patients without sufficient planning and consideration for pediatric trauma populations. Pediatric urotrauma in this setting requires specialty care as part of the humanitarian mission. We determine the incidence of genitourinary trauma and relevant surgical procedures within the pediatric population seen in US military treatment facilities in Afghanistan and Iraq from January 2007 to January 2016.

A scoping review of emergency front of neck access (eFONA) for airway access in the setting of trauma.

Background: Emergency front of neck access (eFONA) is an emergent procedure performed in "cannot intubate, cannot ventilate" scenarios to establish a patent airway that was otherwise compromised. We sought to describe the recent literature on eFONA.

Methods: We conducted a scoping review using the PRISMA-ScR Checklist to provide comprehensive summary of the most relevant eFONA literature over topics such as civilian and military incidence and outcome, available techniques, the use of ultrasound in performing eFONA, training data, complications and contraindications, and emerging data on the procedure.

Prehospital Trauma Compendium: Transfusion of Blood Products in Trauma - A Position Statement and Resource Document of NAEMSP.

Hemorrhagic shock remains the leading cause of potentially preventable death among injured patients with life-threatening bleeding. Prehospital resuscitation has been evolving with increasing use of blood product resuscitation. The impact of blood administration on patient outcomes remains poorly defined with significant heterogeneity in the quality of literature supporting prehospital blood product resuscitation after trauma.

An assessment of laboratory changes during autologous whole blood transfusion training: A prospective, observational study.

Introduction: Hemorrhage is the leading cause of death after trauma. Blood transfusions are used to restore physiology but are stored in citrate preservative which can bind electrolytes, particularly calcium, leading to hypocalcemia. Few data exist on the changes that occur in humans because of whole blood donation/transfusion.

Transfusion quantities associated with 24-h mortality in trauma patients.

Introduction: Data on the correlation between transfusion volumes and trauma mortality are limited. The association between the total number of red blood cell (RBC) and low titer group O whole blood (LTOWB) units, as well as the total volume of all transfused products that were administered up to 4-h after admission and 24-h mortality was determined.

Methods: The Trauma Quality Improvement Program (TQIP) datasets from 2020 to 2022 were reviewed to identify patients aged ≥15 who received any volume of blood products.

Risk of Severe Sepsis After Blood Product Administration for Traumatic Hemorrhage: A Trauma Quality Improvement Program Study.

Introduction: Transfusion of whole blood (WB) for traumatic hemorrhage has generated renewed interest in civilian trauma based on military experience. The association between blood products and severe sepsis remains unknown. We sought to determine which blood products were associated with the development of severe sepsis.

An analysis of transfers into designated trauma centers from referring institutions - the potential for virtual consultation to reduce transfers.

Introduction: Trauma care frequently happens in emergency departments (ED) outside of major trauma centers. Many injuries often exceed the specialty capabilities of referring hospitals, requiring transfer to larger trauma centers. However, the proportion of patients discharged home without admission from receiving facilities remains unclear, suggesting potential overutilization of transfers.

The effect of the proportion of low-titer O whole blood for resuscitation in pediatric trauma patients on 6-, 12- and 24-hour survival.

Introduction: Hemorrhage is a leading cause of death in pediatric patients. Accumulating data suggest that low-titer group O whole blood (LTOWB) improves clinical outcomes in the pediatric population. We examined what ratio of LTOWB to total blood product conferred a survival benefit in transfused pediatric trauma patients.

An Analysis of the Association of Whole Blood Transfusion With the Development of Acute Respiratory Distress Syndrome.

Objectives: To determine the association of whole blood and other blood products (components, prothrombin complex concentrate, and fibrinogen concentrate) with the development of acute respiratory distress syndrome (ARDS) among blood recipients.

Design: Retrospective cohort study.

Setting: American College of Surgeons Trauma Quality Improvement Program (TQIP) database between 2020 and 2021.

An Analysis of Junctional Tourniquet Use Within the Department of Defense Trauma Registry.

Background: Junctional hemorrhage is a leading cause of battlefield death. Multiple FDA-approved junctional tourniquet (JTQ) models demonstrate effective hemorrhage control in laboratory settings. However, there are few real-world use cases within the literature.

An Analysis of 24-Hour Survival Based on Arrival by Atypical Ground Transport Versus Ground Emergency Medical Services.

Objectives: Studies comparing police, privately owned vehicle (POV), and ground Emergency Medical Services (GEMS) trauma transports reveal mixed results. It remains unclear whether using nonstandard transport methods may be beneficial in the setting of certain injuries. We sought to determine 24-h survival after transport by police or POV when compared to GEMS.

Analysis of emergency resuscitative thoracotomy in the combat setting.

Introduction: Emergency resuscitative thoracotomy (ERT) is a resource-intensive procedure that can deplete a combat surgical team's supply and divert attention from casualties with more survivable injuries. An understanding of survival after ERT in the combat trauma population will inform surgical decision-making.

Methods: We requested all encounters from 2007 to 2023 from the Department of Defense Trauma Registry (DoDTR).

Venous thromboembolic events associated with blood product administration in an era of whole blood use.

Background: The risks associated with blood product administration and venous thromboembolic events remains unclear. We sought to determine which blood products were associated with the development of deep vein thrombosis (DVT) and pulmonary embolism (PE).

Methods: We analyzed data from patients ≥18 years of age in the Trauma Quality Improvement Program (TQIP) database that received ≥1 blood product and survived ≥24 ​h.

A Scoping Review of Military Combat Casualty Data on Submassive, Massive, and Supermassive Transfusions.

Introduction: Blood transfusions are common during combat casualty care, aiming to address the loss of blood volume that often accompanies severe battlefield injuries. This scoping review delves into the existing military combat casualty data to analyze the efficacy, challenges, and advances in the use of massive and super-massive transfusions in the management of critically injured warfighters.

Materials And Methods: We performed a scoping review of combat-related literature published between 2006 and 2023 pertaining to massive transfusions used during combat deployments.

A safety and feasibility analysis on the use of cold-stored platelets in combat trauma.

Background: Damage-control resuscitation has come full circle, with the use of whole blood and balanced components. Lack of platelet availability may limit effective damage-control resuscitation. Platelets are typically stored and transfused at room temperature and have a short shelf-life, while cold-stored platelets (CSPs) have the advantage of a longer shelf-life.

An Analysis of Tube Thoracostomy in Combat Implications for Improved Prehospital Recognition and Treatment.

Background: Thoracic trauma occurs frequently in combat and is associated with high mortality. Tube thoracostomy (chest tube) is the treatment for pneumothorax resulting from thoracic trauma, but little data exist to characterize combat casualties undergoing this intervention. We sought to describe the incidence of these injuries and procedures to inform training and materiel development priorities.

Incidence of Coagulopathy After Resuscitation at a Role 1 Facility: The Prehospital Trauma Registry Experience.

Background: The development of acute traumatic coagulopathy is associated with increased mortality and morbidity in patients with battlefield traumatic injuries. Currently, the incidence of acute traumatic coagulopathy in the Role 1 setting is unclear.

Methods: We queried the Prehospital Trauma Registry (PHTR) module of the Department of Defense Trauma Registry (DoDTR) for all encounters from inception through May 2019.